Dietary n-3 polyunsaturated fatty acids improve endothelial markers in metabolic syndrome: A systematic review

ABSTRACT Metabolic syndrome (MS) is a global health problem. Dietary factors, especially fatty acids, may affect MS pathology. However, the associations between omega-3 polyunsaturated fatty acids (n-3 PUFAs) and MS risk demonstrate inconsistent results. To clarify the relationship between dietary n-3 PUFA and endothelial function on MS, we carried out a systematic review. An electronic literature search based on controlled clinical trials (CCTs) between 2004 and 2020 was conducted. A total of 28 articles were included in the systematic review. Studies were analyzed according intervention type: dietary interventions (12 CCTs), dietary supplementation interventions (9 CCTs) and mixed interventions (7 CCTs). Studies with dietary interventions characterized by n-3 PUFAs increased by food source, such as Mediterranean and Nordic-style diets, reported significant reduction in systolic and diastolic blood pressure, and also in inflammatory endothelial biomarkers. The same effect was also observed in mixed interventions and in CCTs with n-3 PUFAs supplementation. Dietary interventions with n-3 PUFAs contributes to improved endothelial and cardiovascular health in SM and associated risk factors.

RESUMEN El síndrome metabólico (SM) es un problema sanitario global. Los factores dietéticos, especialmente los ácidos grasos, pueden afectar la patología del SM. Sin embargo, las asociaciones entre los ácidos grasos poliinsaturados omega-3 (AGPI n-3) y el riesgo de SM pueden ser inconsistentes. Para aclarar esta relación entre AGPI n-3 dietarios y la función endotelial en el SM, realizamos una revisión sistemática. Se realizó una búsqueda bibliográfica en fuentes electrónicas de ensayos clínicos controlados (ECC) entre 2004 y 2020. Se incluyeron un total de 28 artículos en la revisión. Los estudios fueron analizados según intervención realizada: intervención dietaria (12 ECC), intervención con suplementación dietética (9 ECC) e intervenciones mixtas (7 ECC). Los estudios que utilizaron intervenciones dietéticas con aumento de AGPI n-3 a través de alimentos, como las dietas mediterráneas y nórdicas, reportaron una reducción significativa de la presión arterial sistólica (PAS), diastólica (PAD) y de biomarcadores endoteliales inflamatorios. El mismo efecto se observó en intervenciones mixtas y ECC con suplementación de AGPI n-3. Las intervenciones dietéticas con AGPI n-3 contribuyen a mejorar la salud endotelial y cardiovascular y sus factores de riesgo asociados.

Dietary patterns and blood pressure in Southern Cone of Latin America.

BACKGROUND AND AIMS: in the Southern Cone of Latin America, previous studies have shown that blood hypertension is one of the most significant risk factor for cardiovascular disease, and diet plays a fundamental role. We analyzed the cross-sectional relationship between dietary patterns (DP) and blood pressure values in people involved in the CESCAS I Study. METHODS AND RESULTS: the participants (n = 4626) were derived from randomly selected samples in 4 cities (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay). To define DP, a food-frequency questionnaire was applied and principal component analysis was performed. Blood pressure was determined according to standardized guidelines. A multivariate regression model was developed to determine the association between each DP and blood pressure values, according to the quartile (Q) of adherence to DP. Two predominant DP were detected, Prudent (PDP, higher consumption of fruits, vegetables, legumes, whole grains, fish, seafood and nuts) and Western (WDP, higher consumption of red and processed meats, dressings, sweets, snacks and refined grains). A significant inverse association was found between adherence to PDP and systolic and diastolic blood pressure (-1.85 and -1.29 mmHg for Q4 vs Q1, respectively). Adherence to WDP was positively associated with systolic blood pressure (2.09 mmHg for Q4 vs Q1). CONCLUSION: the WDP detected in the studied population is positively associated with higher levels of blood pressure, while greater adherence to healthy DP has a positive impact on blood pressure.

Omega-3 and Omega-6 salivary fatty acids as markers of dietary fat quality: A cross-sectional study in Argentina.

The use of saliva for analyzing biological compounds has recently been expanded. The aim of this study was to analyze the correlation between specific dietary sources of n3 and n6 fatty acids (FA) and their salivary levels to evaluate their role as intake markers. Seventynine healthy volunteers were included. A validated food frequency questionnaire was used for data collection and Interfood v.1.3 software was employed to quantify food intake. Salivary samples were collected following international standards and FA profile was determined by gas liquidchromatography. Multiple linear regression analyses were performed for dependent variables (salivary FA profile) to detect independent associations with n3 and n6 FA food source intake, adjusted by age, gender, bodymass index, total energy intake, regular exercise, alcohol intake and smoking. Salivary concentrations of alphalinolenic acid (ALA) 18:3 n3 were significantly associated with nuts intake (ß=0.05, 95% CI 0.020.07, p=0.04). Salivary concentrations of linoleic acid (LA) 18:2 n6 and arachidonic acid (AA) 20:4 n6 were associated with the intake of n6 vegetable oils and red meat, cold meat and viscera (ß=0.80, 95% CI 0.060.09 p=0.03; ß=0.40, 95% CI 0.300.50, p=0.02, respectively). This study supports the hypothesis that salivary concentrations of n3 and n6 FA are related to food intake. Monitoring dietary FA though salivary markers is relevant for nutrition epidemiology and for prevention and management of several diseases related to fat intake.

El uso de biomarcadores salivales está en continua expansión. El objetivo de este estudio fue analizar la asociación entre fuentes alimentarias de ácidos grasos (AG) n3 y n6 y sus concentraciones salivales como marcador de ingesta. Parti ci paron 79 voluntarios sanos. Se aplicó un cuestionario validado de frecuencia de consumo alimentario y el software Interfood v.1.3 para su procesa miento. Las muestras saliva les se recogieron según estándares internacionales y se determinó el perfil de AG salivales por cromatografía gaseosa. Se desarrolló un modelo de regresión lineal múltiple ajustado por sexo, edad, índice de masa corporal, valor energético total, actividad física, consumo de tabaco y alcohol para analizar la asociación entre el perfil de AG salivales y la ingesta de alimentos fuente de AG n3 y n6. Las concentraciones salivales del AG alfalinolénico (ALA) 18:3 n3 se asociaron positivamente con la ingesta de nueces (ß=0.05, IC 95% 0.020.07, p=0.04), mientras que las concentraciones salivales de ácido linoleico (AL) 18:2 n6 y araquidónico (AA) 20:4 n6 se asociaron con el consumo de aceites ricos en n6 (ß=0.80, 95% IC 0.060.09 p=0.03) y de carnes rojas, fiambres y embutidos y vísceras, (ß=0.40, IC 95% 0.300.50, p=0.02). De acuerdo a estos resultados, las concen traciones salivales de AG n3 y n6 se relacionan a la ingesta de sus alimentos fuente. El monitoreo de la ingesta lipídica a través de biomarcadores salivales constituye un aporte a la epidemiología nutricional y a la prevención y tratamiento de patologías vinculadas a la ingesta de grasas.

[Validity and reproducibility of a food frequency questionnaire to assess lipid and phytochemical intake]. / Validación y reproducibilidad de un cuestionario de frecuencia de consumo alimentario para valorar la ingesta de lípidos y fitoquímicos.

BACKGROUND: epidemiological studies have been related food intake with the incidence of non-transmissible chronic diseases. OBJECTIVE: the purpose of the present study was to analyze the validity and reproducibility of a food frequency questionnaire (FFQ) aimed at assessing lipid and phytochemical intake. MATERIAL AND METHODS: FFQ was administered to 45 people of both sexes, aged between 20 and 72 years old and resident in Cordoba, Argentina. The FFQ included 257 questions referring to foods, their consumption frequency and portion size. Regarding consumption of fruit and vegetables, the season was also taken into account. The questionnaire was applied at two different periods (FFQ1 and FFQ2) with a break of six months in between. As a reference, the 24-hour dietary recall was used (24HDR) three times. The mid intake of FFQ1-FFQ2, the 24HDR-FFQ2 median intake, median difference, Mean Absolute Deviation from the median differences (MAD), Wilcoxon signed rank sum test and Spearman rank order correlation coefficients were calculated to analyze the accuracy of the FFQ data. RESULTS: the correlation coefficients for FFQ1-FFQ2 varied from 0.52 for 20:5 n3 eicosapentanoic (EPA) fatty acid to 0.89 for 4:0 butyric fatty acid (p<0.05). For 24HDR-FFQ2, the values ranged from 0.19 for lycopene to 0.93 for EPA fatty acid (p<0.05). CONCLUSION: the analysis carried out showed an acceptable validity and reproducibility of the FFQ, thus enabling it to be used in research relating the intake of lipids and phytochemicals and the risk of non-transmissible diseases.

Antecedentes: estudios epidemiológicos sugieren que el consumo de ciertos alimentos puede reducir el riesgo de enfermedades no transmisibles (ENT). Objetivo: analizar la validez y reproducibilidad de un cuestionario de frecuencia de consumo alimentario (FFQ) destinado a evaluar la ingesta de lípidos y fitoquímicos. Material y métodos: el FFQ fue administrado a 45 personas de ambos sexos, con edades entre 20 y 72 años de edad, residentes en Córdoba, Argentina. Incluyó 257 preguntas referidas a los alimentos, su frecuencia de consumo y tamaño de la porción. Se consideró la estacionalidad para el consumo de frutas y verduras. El cuestionario se aplicó en dos períodos diferentes (FFQ1 y FFQ2) con un intervalo de seis meses y se acompañó por un recordatorio de 24 horas (24HDR) utilizado en tres periodos de tiempo. Se realizó la estimación de: ingesta promedio FFQ1-FFQ2 y 24HDR-FFQ2, diferencia de medias, desviación absoluta de diferencias de medias, prueba de los rangos con signo de Wilcoxon y test de correlación de Spearman. Resultados: los coeficientes de correlación para FFQ1-FFQ2 variaron de 0,52 para el ácido graso eicosapentanoico 20:5 n3 (EPA) a 0,89 para ácido graso butírico 4:0 (p<0,05). Para 24HDR-FFQ2, los valores de correlación oscilaron entre 0,19 para licopeno y 0,93 para el EPA (p <0,05). Conclusión: el análisis realizado mostró una validez aceptable y reproducibilidad del FFQ, permitiendo así que sea utilizado en investigaciones sobre ingesta de lípidos y fitoquímicos y el riesgo de ENT.

Validation of a self-administered FFQ in adults in Argentina, Chile and Uruguay.

OBJECTIVE: To assess the reproducibility and validity among adults in the Southern Cone of Latin America (Argentina, Chile and Uruguay) of a self-administered FFQ to be used in the CESCAS I Study, an ongoing observational prospective cohort study to detect and follow up CVD and their risk factors, as well as in other epidemiological studies. DESIGN: Relative validity of the FFQ was evaluated by comparing nutrient and selected food group intakes with those from three 24 h recalls (24HR) administered over 6 months. The FFQ was administered at baseline (FFQ1) and again after 3 months (FFQ2). SETTING: Primary-care centres in Argentina, Chile and Uruguay. SUBJECTS: Adults (n 147) aged 21-74 years. RESULTS: Reproducibility (FFQ1 v. FFQ2): the intra-class correlation coefficients for nutrients ranged from 0·52 (potassium) to 0·74 (fat). Validity (FFQ1 v. the average of three 24HR): the Pearson correlations for energy-adjusted nutrients ranged from 0·39 (thiamin and cholesterol) to 0·59 (carbohydrate). Joint classification: overall, 66 % of participants in the lowest 24HR quintile were in the lowest one or two FFQ1 quintiles, and 62 % of those in the highest 24HR quintile were in the highest one or two FFQ1 quintiles. On average, only 4 % were misclassified into extreme quintiles. CONCLUSIONS: The FFQ version for the Southern Cone seems to present moderate to acceptable relative validity and reliability for its use in the CESCAS I Study to measure dietary exposure.

[Human milk in hospitalized premature neonates and nutritional evolution]. / Aporte de leche materna en el recién nacido prematuro hospitalizado y evolución nutricional.

BACKGROUND: Preterm infants require special considerations than term infants to obtain adequate growth. OBJECTIVE: The aim was to evaluate human milk (HM) in low birth weight premature newborn (LBW-PN) and very low birth weight (VLBW-PN) during hospitalization, maternal factors, and the relationship with nutritional parameters. MATERIAL AND METHODS: 87 LBW-PN and 82 VLBW-PN), admitted in a public hospital in Córdoba, Argentina, were included. Anthropometry, food and biochemical parameters, and child and maternal history were registered. HM contribution was calculated. Anthropometric and biochemical values, days of hospitalization and maternal factors by HM intake were analyzed. RESULTS: Only 36,36% of VLBW-PN and 31,02% of LBW-PN had more than 20% of their diet with HM. The hemoglobin concentration at discharge was higher in VLBW-PN group with more HM (p=0,01). There was a statistically significant association between HM amount and height at discharge in the PN with less than 20% of their diet with HM. A high prevalence of cesarean delivery was observed, related to lower HM. CONCLUSIONS: HM contributes to hemoglobin stabilization. Cesarean delivery may be associated with lower contribution of HM to newborn infants.

Antecedentes: El nacimiento pretérmino es una emergencia nutricional y requiere consideraciones especiales. Objetivos: Se propuso evaluar el aporte de leche humana (LH) en el recién nacido prematuro hospitalizado de bajo peso (RNP-BP) y muy bajo peso (RNP-MBP), factores maternos y su relación con parámetros nutricionales. Materiales y métodos: Participaron 87 RNP-BP y 82 RNP-MBP admitidos en un hospital público en Córdoba, Argentina. Se registró la antropometría evolutiva, alimentación, parámetros bioquímicos, antecedentes del niño y maternos. Se calculó el aporte de LH. Se analizaron los valores antropométricos y bioquímicos, días de internación y factores maternos según aporte de LH. Resultados: El 36,36% de los RNP-MBP y el 31,02% de los RNP-BP cubrió más del 20% de su alimentación con LH. La hemoglobina sérica fue superior en RNP-MBP que recibieron más LH (p=0,01). Los RNP con menos del 20% de su alimentación con LH presentaron una asociación estadísticamente significativa entre la cantidad de LH y la talla al alta hospitalaria. Se observó una elevada prevalencia de cesáreas, asociada a un menor aporte de LH. Conclusiones: El aporte de LH contribuiría a estabilizar la hemoglobina en RNP. La presencia de cesárea podría asociarse a un menor aporte de LH a los RNP.

Aporte de leche materna en el recién nacido prematuro hospitalizado y evolución nutricional / [Human milk in hospitalized premature neonates and nutritional evolution].

BACKGROUND: Preterm infants require special considerations than term infants to obtain adequate growth. OBJECTIVE: The aim was to evaluate human milk (HM) in low birth weight premature newborn (LBW-PN) and very low birth weight (VLBW-PN) during hospitalization, maternal factors, and the relationship with nutritional parameters. MATERIAL AND METHODS: 87 LBW-PN and 82 VLBW-PN), admitted in a public hospital in Córdoba, Argentina, were included. Anthropometry, food and biochemical parameters, and child and maternal history were registered. HM contribution was calculated. Anthropometric and biochemical values, days of hospitalization and maternal factors by HM intake were analyzed. RESULTS: Only 36,36

of VLBW-PN and 31,02

of their diet with HM. The hemoglobin concentration at discharge was higher in VLBW-PN group with more HM (p=0,01). There was a statistically significant association between HM amount and height at discharge in the PN with less than 20

of their diet with HM. A high prevalence of cesarean delivery was observed, related to lower HM. CONCLUSIONS: HM contributes to hemoglobin stabilization. Cesarean delivery may be associated with lower contribution of HM to newborn infants.

Aporte de leche materna en el recién nacido prematuro hospitalizado y evolución nutricional. / [Human milk in hospitalized premature neonates and nutritional evolution].

BACKGROUND: Preterm infants require special considerations than term infants to obtain adequate growth. OBJECTIVE: The aim was to evaluate human milk (HM) in low birth weight premature newborn (LBW-PN) and very low birth weight (VLBW-PN) during hospitalization, maternal factors, and the relationship with nutritional parameters. MATERIAL AND METHODS: 87 LBW-PN and 82 VLBW-PN), admitted in a public hospital in Córdoba, Argentina, were included. Anthropometry, food and biochemical parameters, and child and maternal history were registered. HM contribution was calculated. Anthropometric and biochemical values, days of hospitalization and maternal factors by HM intake were analyzed. RESULTS: Only 36,36

of VLBW-PN and 31,02

of LBW-PN had more than 20

of their diet with HM. The hemoglobin concentration at discharge was higher in VLBW-PN group with more HM (p=0,01). There was a statistically significant association between HM amount and height at discharge in the PN with less than 20

of their diet with HM. A high prevalence of cesarean delivery was observed, related to lower HM. CONCLUSIONS: HM contributes to hemoglobin stabilization. Cesarean delivery may be associated with lower contribution of HM to newborn infants.

Biomarker assessment in nutritional modulation of oxidative stress-induced cancer development by lipid-related bioactive molecules.

Cancer, a leading cause of death, can be prevented by different nutrients, in accordance to epidemiological and experimental data. Cancer chemoprevention might involve different dietary substances, which can counteract genetic damage and modulate the acquisition of a neoplastic phenotype. Critical to this process is redox cellular homeostasis, with antioxidants and essential biomolecules being the most promising functional compounds of the diet. Nutritional interventions require accurate biomarkers in order to evaluate their appropriateness. Such parameters may be biological targets involved in the oncogenetic process, and biochemical changes deriving from the organic response to tumours, which can be considered as endpoints of dietary interventions. This review will thus focus on patents on recent progress in the development of redox-related anticancer nutritional interventions involving lipophilic compounds, and of biological markers for evaluating them, with their scientific basis being reviewed.

[Development of a software program for nutrition studies]. / Desarrollo de un programa informático para estudios nutricionales.

The Interfood v. 1.3 software program was developed to process nutrition information and generate data on dietary intakes--in terms of food, nutrients, and phytochemical substances--valid for conducting studies on nutrition and epidemiology. The program has three basic components: the dietary intake frequency questionnaire CFCA); a database of common foods and their composition of 131 possible substances (macro- and micronutrients and phytochemicals); and a relational database that links the CFCA data with the food database. In this manner, the Interfood software program calculates the amount of food, nutrients, and phytochemical substances consumed by an individual daily, weekly, and monthly. Interfood is an open-source program; as such, the database can be modified and updated according to study requirements. This program has already proven useful to various studies of nutrition and epidemiology.

Desarrollo de un programa informático para estudios nutricionales / Development of a software program for nutrition studies

Se desarrolló el programa informático Interfood v. 1.3 para procesar la información alimentaria y generar datos sobre el consumo dietético -en términos de alimentos, nutrientes y sustancias fitoquímicas- válidos para realizar estudios nutricionales y epidemiológicos. El programa se basa en tres componentes fundamentales: el cuestionario de frecuencia de consumo alimentario (CFCA); una base de datos de alimentos frecuentes y su contenido en 131 compuestos (macro y micronutrientes y sustancias fitoquímicas); y una base de datos relacional que asocia la información del CFCA con la base de datos de alimentos. De esta forma, el programa informático Interfood calcula la cantidad de cada uno de los alimentos y los nutrientes y las sustancias fitoquímicas que una persona consume por día, semana y mes. Interfood es un programa de código abierto, por lo que sus bases de datos se pueden modificar y actualizar de acuerdo con las necesidades de la investigación. Este programa ya ha demostrado su utilidad en diversas investigaciones nutricionales y epidemiológicas.

The Interfood v. 1.3 software program was developed to process nutrition information and generate data on dietary intakes-in terms of food, nutrients, and phytochemical substances-valid for conducting studies on nutrition and epidemiology. The program has three basic components: the dietary intake frequency questionnaire CFCA); a database of common foods and their composition of 131 possible substances (macro- and micronutrients and phytochemicals); and a relational database that links the CFCA data with the food database. In this manner, the Interfood software program calculates the amount of food, nutrients, and phytochemical substances consumed by an individual daily, weekly, and monthly. Interfood is an open-source program; as such, the database can be modified and updated according to study requirements. This program has already proven useful to various studies of nutrition and epidemiology.